Diet and Health FAQ

Tagged As: Bowel Syndrome

Question:
Can you have irritable bowel syndrome with blood in your stool?  I was given a diagnosis of IBS by my gastro and I'm a bit confused by this.

Answer:
You may well have IBS, but it isn't causing the blood in your stool. Something else is causing that.  Although indirectly, I guess, the IBS could cause constipation, which could cause hemorrhoids or anal fissures.  With anal fissures you usually see blood on the toilet paper but not so much on the stool itself.  Hemorrhoids tend to bleed a little more than fissures and you're more likely to see some blood in the toilet.  If your gastroenterologist told you the IBS itself directly causes bloody stools, I'd get a second opinion. I get diarrhea rather than constipation.  Without wanting to be too graphic, I pass a fair amount of mucus when this happens, and the blood is mixed in with the mucus, most noticeable on the paper.  The amount of blood is relatively minor and usually just tinges the mucus.  When I do see any blood on its own it is bright red. I saw the gastro about six months ago.  He took my history and did a sigmoidoscopy, the biopsy results of which were normal.  He actually gave me a diagnosis of 'irritable rectum syndrome' rather than IBS but all I can find out about that is that it's a subset of IBS.  Maybe he just meant that I seemed like an irritable rectum He didn't give any opinion at all on the blood.  Your mention of hemorrhoids makes me wonder if the straining may be causing those kinds of problems... Bloody stools is not on anybody's list of symptoms for IBS.  People with IBS often have mucus in their stools, though.  Chances are he's diagnosed IBS because he feels confident he's ruled out ulcerative colitis and Crohn's disease with the biopsies and the sigmoidoscopy. I've observed that incidents like this are more often failures in patient education than failures in diagnosis.  In your place I might call and ask him to explain how he's ruled out these other conditions, considering the blood in your stools.  After that conversation you'll either understand his reasoning and feel reassured, or you'll feel like you need another gastro.